Friday, November 1, 2013. On October 15, 2013, the International Journal of Clinical Practice reported the finding of Abdulmaged M. Traish, MBA, PhD of Boston University School of Medicine and his associates of a beneficial effect for testosterone therapy in lowering metabolic syndrome and related cardiovascular disease risk in hypogonadal men.

The study included 255 men aged 33 to 69 years who had sought treatment for symptoms related to low testosterone and had low plasma total testosterone levels upon assessment. All men were treated with testosterone at the beginning of the study period, at six weeks, and every twelve weeks thereafter for up to five years. Weight, height and waist circumference were measured at these time points, and blood samples were assessed for lipids, fasting glucose, hemoglobin A1c, C-reactive protein (CRP, a marker of inflammation) and liver enzymes. All but eleven of the men included in the study had three or more metabolic syndrome components, which include increased waist circumference, hypertension, disordered lipids and insulin resistance.

Treatment with testosterone nearly doubled levels of the hormone within the first year, after which concentrations remained consistent for the remainder of the observation period. Total cholesterol, which averaged 282 milligrams per deciliter (mg/dL) before treatment, was reduced to an average of 188 mg/dL after two years and remained stable. Low-density lipoprotein (LDL) cholesterol and triglycerides showed a similar pattern of decline, while high-density lipoprotein (HDL) increased.

In addition to the benefits in lipid levels observed, the men experienced a decrease in systolic and diastolic blood pressure, fasting glucose, hemoglobin A1c, CRP, and liver enzymes (which, when elevated, are associated with liver dysfunction, as well as an increased risk of metabolic syndrome).

"These findings suggest that long-term treatment of men with testosterone deficiency restoring physiological levels of testosterone produces important clinical benefits," the authors write. "This study differs from previous studies in that it followed men with testosterone deficiency for a period of five years, which is the longest reported duration of treatment to date."

"These data are congruent with our previous work in which we reported that long-term testosterone resulted in a gradual decline in weight and waist circumference and strongly suggests that testosterone therapy in hypogonadal men may prove useful in reducing the risk of cardiometabolic diseases," Dr Traish concluded.

Cheryl R. Clark, MD, ScD and her colleagues analyzed data from 23,168 men and women who participated in the 1999-2010 National Health and Nutrition Examination Survey (NHANES). Overall, dietary fiber intake was below recommended adequate intake levels, with non-Hispanic blacks reporting the lowest intake. In comparison with those whose intake was among the lowest 20% of the subjects, men and women whose intake was among the highest 20% had a 22% lower risk of metabolic syndrome, a 34% lower risk of inflammation and a 23% lower risk of obesity. When the participants were examined according to race, a protective effect for fiber against obesity and metabolic syndrome was observed among Caucasians, while fiber was protective against inflammation in all groups.

"Overall, the prevalence of the metabolic syndrome, inflammation, and obesity each decreased with increasing quintiles of dietary fiber intake," she observed. "Low dietary fiber intake from 1999-2010 in the US and associations between higher dietary fiber and a lower prevalence of cardiometabolic risks suggest the need to develop new strategies and policies to increase dietary fiber intake," Dr Clark added. "Additional research is needed to determine effective clinical and population-based strategies for improving fiber intake trends in diverse groups."

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